Provider Demographics
NPI:1376787739
Name:PAULA PYLE MD, LLC
Entity Type:Organization
Organization Name:PAULA PYLE MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PAU;A
Authorized Official - Middle Name:B
Authorized Official - Last Name:PYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-332-7760
Mailing Address - Street 1:PO BOX 2220
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2220
Mailing Address - Country:US
Mailing Address - Phone:850-332-7760
Mailing Address - Fax:850-497-6695
Practice Address - Street 1:975 ROYCE ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2463
Practice Address - Country:US
Practice Address - Phone:850-332-7760
Practice Address - Fax:850-497-6695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0079342207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260383700Medicaid
FL49946OtherBCBS FL
FL49946YMedicare PIN